Paramedic Test Prep Study Guide

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  1. Paramedic Protocol 2018(Rev. 1-2-18) What is the definition of Level I treatments? pg 1***
    NO BASE CONTACT NEEDED
  2. Paramedic Protocol 2018(Rev. 1-2-18) - What are the requirements for Level II treatments? Pg.1***
    Make base contact. Continue if radio failure.
  3. Paramedic Protocol 2018(Rev. 1-2-18) - What should you consider in all unresponsive patients? Pg.3***
    Narcan, blood glucose analysis and Dextrose (if hypoglycemic) in all unresponsive patients including cardiopulmonary arrest***
  4. Paramedic Protocol 2018(Rev. 1-2-18) - What are the Level II protocols? Pg.4***
    • Cricothyrotomy
    • Thoracic decompression
    • Administer 9 additional drugs
  5. Paramedic Protocol 2018(Rev. 1-2-18) - What are Paramedics authorized during inter-facility patient transfers? Pg.4***
    Monitor IV’s of Potassium Chloride with less than 40 mEq, per liter ***
  6. Paramedic Protocol 2018(Rev. 1-2-18) - LEVEL II PARAMEDIC PROCEDURES - Cricothyrotomy Comments*** pg 54
    When may a Cricothyrotomy device be used?
    Only if ventilation attempts by all other means are unsuccessful. Division approved device is a 10g IV catheter.
  7. Paramedic Protocol 2018(Rev. 1-2-18) - DESTINATION DECISION - What is considered a significant ED OVERLOAD SCORE?*** pg 6
    Greater than 5 (Step 4)
  8. Paramedic Protocol 2018(Rev. 1-2-18) - DESTINATION DECISION Trauma - Where do you transport Step 1 or 2 trauma activations?*** pg 7
    KM
  9. Paramedic Protocol 2018(Rev. 1-2-18) - DESTINATION DECISION STEMI*** pg 7
    • BMH
    • Heart
    • AH-B (Adventist Health – Bakersfield)
  10. Paramedic Protocol 2018(Rev. 1-2-18) - DESTINATION DECISION Sexual Assault***pg 7
    AH-B (Adventist Health – Bakersfield)***
  11. Paramedic Protocol 2018(Rev. 1-2-18) - V-Fib / V Tach - The pause in chest compressions to check the rhythm and pulse should less than how many seconds?*** pg 21
    10 seconds
  12. Paramedic Protocol 2018(Rev. 1-2-18) - V-Fib / V Tach - For a cardiac arrest patient in VF/VT who has a body temperature of (<86oF), How many defibrillation(s) attempt are appropriate?*** pg 20
    One***
  13. Paramedic Protocol 2018(Rev.1-2-18) - CPR PEA Which of the H’s and T’s in PEA is most common?*** pg 22
    Hypovolemia and hypoxia***
  14. Paramedic Protocol 2018(Rev. 1-2-18) - TACHYCARDIA WITH A PULSE - What is the treatment sequence for a stable patient with a wide QRS and a regular rate?*** pg 23
    GIVE AMIODARONE 150 MG IN 100 ML OF NS IV/IO OVER 10 MIN, repeat to a MAX DOSE 450MG***
  15. Paramedic Protocol 2018(Rev. 1-2-18) - TACHYCARDIA WITH A PULSE - What is the treatment sequence for a stable patient with a narrow QRS *** pg 23
    • Vagal maneuver then
    • Adenosine Rapid IVP 6mg, 12mg,12mg max of 30mg
  16. Paramedic Protocol 2018(Rev. 1-2-18) - TACHYCARDIA WITH A PULSE - What should you do if the patient is unstable and conscious and you need to cardiovert?*** pg 24
    Provide sedation to a conscious patient if possible, but do not delay cardioversion if the patient is unstable.***
  17. Paramedic Protocol 2018(Rev. 1-2-18) - BRADYCARDIA -What should the starting pace rate be?*** pg 26
    80***
  18. Paramedic Protocol 2018(Rev. 1-2-18) - BRADYCARDIA - What dose of Atropine should you give?*** pg 25
    0.5MG IV. MAY REPEAT TO A TOTAL DOSE OF 3 MG
  19. Paramedic Protocol 2018(Rev. 1-2-18) - BRADYCARDIA - When should you start TCP immediately?*** pg 26
    No response to atropine***
  20. Paramedic Protocol 2018(Rev. 1-2-18) - CHEST PAIN/ACUTE CORONARY SYNDROME - What is the maximum time to obtain a 12-lead ECG?*** pg 28
    Do not delay treatment or transport beyond 2-3 minutes to obtain 12-lead ECG***
  21. Paramedic Protocol 2018(Rev. 1-2-18) - (CVA) AND ACUTE STROKE- Apply oxygen only if pulse ox is less than what %? pg 31
    94%
  22. Paramedic Protocol 2018(Rev. 1-2-18) - (CVA) AND ACUTE STROKE- What position should you transport a stroke patient?*** pg 31
    Semi-Fowler’s position with no more than 30 degrees head elevation***
  23. Paramedic Protocol 2018(Rev. 1-2-18) - PEDIATRIC PULSELESS ARREST/ENTRY ALGORHITHM - Should you allow the family to remain present during resuscitation?***pg 34
    Consider allowing the family to remain present during resuscitation. ***
  24. Paramedic Protocol 2018 Tachycardia with a pulse(Rev. 1-218) - How should you deliver low energy shocks during Cardioversion? pg 24
    Low energy shocks should always be delivered as synchronized shocks. Low energy unsynchronized shocks (defibrillation) are likely to induce VF. If cardioversion is needed and it is not possible to synchronize a shock, use unsynchronized shocks (defibrillation) at defibrillation doses.
  25. Paramedic Protocol 2018(Rev. 1-2-18) - PEDIATRIC VF/PULSELESS VT-The pause in chest compressions to check the rhythm and pulse should not exceed how many seconds?***pg 37
    10 seconds***
  26. Paramedic Protocol 2018(Rev. 1-2-18) - PEDIATRIC VF/PULSELESS VT- What should you do for a cardiac arrest patient in VF/VT who has a body temperature of <30oC (<86oF)?***pg 37
    A single defibrillation attempt is appropriate. If the patient fails to respond to the initial defibrillation attempt, defer subsequent attempts and drug therapy until the core temperature rises above 30oC (86oF).***
  27. Paramedic Protocol 2018(Rev. 1-2-18) - NEONATAL RESUSCITATION - What is the recommended ratio for compressions to ventilations?***pg 47
    3:1 with 90 compressions and 30 breaths to achieve 120 events per minute***
  28. Paramedic Protocol 2018(Rev. 1-2-18) - ALTERED MENTAL STATUS - When should 10% dextrose be administered?*** pg 57
    When blood glucose is below 60***
  29. Paramedic Protocol 2018(Rev. 1-2-18) - BURNS - How do you treat burns to large body surface areas?*** pg 61
    They should be cooled initially to stop burning process and then wrapped in dry, sterile dressing to prevent hypothermia***
  30. Paramedic Protocol 2018(Rev. 1-2-18) - PATIENT RESTRAINT - How should Restraints should be secured?***pg 69
    To a non- moving part of a gurney and tied in a fashion that will allow for quick release***
  31. Paramedic Protocol 2018(Rev. 1-2-18) - POSTPARTUM HEMORRHAGE - Postpartum hemorrhage is characterized by? *** pg 73
    Acute blood loss of (Greater than) >500 mL after delivery of the newborn***
  32. Paramedic Protocol 2018(Rev. 1-2-18) - RESPIRATORY COMPROMISE-ADULT - What is indicated with minor to moderate cases of bronchospasm not responsive to albuterol?***pg 75
    Subcutaneous Epinephrine 1:1000 0.3 MG, IM or IV Drip 2-8mcg/minute
  33. Paramedic Protocol 2018(Rev. 1-2-18) - RESPIRATORY COMPROMISE-ADULT - What can be administered to reduce myocardial workload and oxygen consumption in cases of pulmonary edema?*** pg 75
    • Nitroglycerin 0.4 MG SL
    • CONSIDER CPAP IF AVAILABLE AND BP > 90 SYSTOLIC
  34. Paramedic Protocol 2018(Rev. 1-2-18) - HEAD TRAUMA - What are the signs of Cushing’s Triad?*** pg 84
    • Decreased heart rate
    • Increased blood pressure
    • Increased respiratory rate.
  35. Paramedic Protocol 2018(Rev. 1-2-18) - HEAD TRAUMA - What is the goal for blood pressure?*** pg 84
    80-90 systolic.***
  36. Paramedic Protocol 2018(Rev. 1-2-18) - SHOCK/HYPOPERFUSION - A patient with a suspected volume loss, what is the treatment sequence? pg 85
    • Large bore IV
    • 250 ML Fluid Challenge
    • CONSIDER additional Bolus if BP <90
    • If transport time >30 min and BP<80 consider dopamine 2-10/mcg/kg/min titrated to BP>90
  37. Paramedic Protocol 2018(Rev. 1-2-18) - SHOCK/HYPOPERFUSION - A patient WITHOUT a suspected volume loss, what is the treatment sequence? pg 85
    • Large bore IV
    • 250 ML Fluid Challenge
    • BP STILL<90 systolic 
    • consider dopamine 2-10/mcg/kg min titrated to bp>90
  38. Paramedic Protocol 2018(Rev. 1-2-18) -TRAUMATIC CARDIAC ARREST - What do you do if you suspect a possible TENSION PNEUMOTHORAX? pg 88
    Tension pneumothorax requires immediate decompression
  39. Paramedic Protocol 2018(Rev. 1-2-18) - 12-LEAD EKG - What should you do if the monitor indicates "ACUTE MI”*** pg 91
    CONTACT A STEMI RECEIVING CENTER AND ADVISE “STEMI ALERT”***
  40. Paramedic Protocol 2018(Rev. 1-2-18) - 12-LEAD EKG - What shall be the trigger for the notification of a “STEMI Alert? pg 92
    The monitor’s interpretation, on the printed 12 Lead EKG
  41. Paramedic Protocol 2018(Rev. 1-2-18) - 12-LEAD EKG - Who receives a copy of the 12 lead EKG? pg 93
    • A copy must be maintained by the transporting agency
    • The hospital ED for inclusion in the patient chart. The 12 lead EKG print-out shall be presented to hospital staff at the time the patient is delivered.
    • A copy made available to EMS upon request
  42. Paramedic Protocol 2018(Rev. 1-2-18) - CONTINUOUS POSITIVE AIRWAY PRESSURE - What criteria must be met?*** pg 94
    • Age >8 Y/O
    • Patient A+O and able to follow commands
    • Patient has the ability to maintain an open airway (GCS>10)
    • Systolic BP > 90
  43. Paramedic Protocol 2018(Rev. 1-2-18) - CONTINUOUS POSITIVE AIRWAY PRESSURE - What are the four signs and symptoms that two must be present?***pg 94
    • RESPIRATORY RATE > 25 BREATHS PER MIN
    • RETRACTIONS OR ACCESSORY MUSCLE USE
    • PULSE OXIMETRY <94%
    • ADVENITIOUS (ABNORMAL) OR DIMINISHED LUNG SOUNDS
  44. Paramedic Protocol 2018(Rev. 1-2-18) - CONTINUOUS POSITIVE AIRWAY PRESSURE - What are the five contraidications?*** pg 94
    • Agonal or absent respiration
    • Suspected pneumothorax or penetrating chest trauma
    • Patient has a tracheostomy
    • Systolic BP<90
    • Risk of aspiration
  45. Paramedic Protocol 2018(Rev. 1-2-18) - CONTINUOUS POSITIVE AIRWAY PRESSURE - What is a more important factor than the age in determining eligibility for CPAP? Pg 95
    The size and anatomy of the patient
  46. Paramedic Protocol 2018(Rev. 1-2-18) - CONTINUOUS POSITIVE AIRWAY PRESSURE- CPAP***- Which patients may receive CPAP? pg 95
    CPAP is approved for use on adults and children eight (8) and older.
  47. Paramedic Protocol 2018(Rev. 1-2-18) - CONTINUOUS POSITIVE AIRWAY PRESSURE - How often must vital signs must be recorded?*** pg 95
    Every 5 minutes
  48. Paramedic Protocol 2018(Rev. 1-2-18) - CONTINUOUS POSITIVE AIRWAY PRESSURE - What vital signs must be recorded? pg 95
    • Respiratory rate
    • Heart rate
    • Blood pressure
    • Sp02
  49. Paramedic Protocol 2018(Rev. 1-2-18) - CONTINUOUS POSITIVE AIRWAY PRESSURE - Can a CPAP patient be transferred to a Paramedic that has not been trained on the use of CPAP? pg 95
    NO
  50. Paramedic Protocol 2018(Rev. 1-2-18) - SPINAL MOTION RESTRICTION - Who receives spinal immobilization?*** pg 97
    • Posterior midline spinal pain or tenderness with a history of or suspicion of trauma.
    • Numbness or weakness in any extremity after trauma.
    • Injuries distracting patient from distinguishing spinal pain (e.g., pelvic fracture, multi-system trauma, crush injury to hands or feet, long bone fracture proximal to the knee/elbow, or to the humerus/femur.)
    • Altered Mental Status GCS <15.
    • Intoxication.
    • Language Barrier, unless reliable translation is available.
    • Age less than 3 or greater than 65.
  51. Paramedic Protocol 2018(Rev. 1-2-18) - SPINAL MOTION RESTRICTION - Does mechanism of injury alone determine spinal immobilization?***pg 97
    No***
  52. Paramedic Protocol 2018(Rev. 1-2-18) - SPINAL MOTION RESTRICTION - What does complete spinal motion restriction include? pg 97
    cervical collar (C-Collar) and gurney straps or seatbelts only. Head blocks may be used to prevent rotation.
  53. Paramedic Protocol 2018(Rev. 1-2-18) - SPINAL MOTION RESTRICTION - May a paramedic remove spinal immobilization precautions previously placed on patients?*** pg 98
    Yes, after a patient assessment using the standards stated in Section 1 of the Spinal Immobilization protocol
  54. Paramedic Protocol 2018(Rev. 1-2-18) - BLOOD PRODUCT TRANSFER - May paramedics transfer patients that are receiving blood products?*** pg 101
    No (as of 1-3-18 memo)
  55. Paramedic Protocol 2018(Rev. 1-2-18) - INTER-FACILITY TRANSFER PORTABLE VENTILATOR – What are the indications? Pg 100
    Continuation of ventilator controlled respirations on chronic ventilator dependent patients during inter-facility transfers.
  56. Paramedic Protocol 2018(Rev. 1-2-18) - INTER-FACILITY TRANSFER PORTABLE VENTILATOR – What are the contraindications? Pg 100
    • Hemodynamically unstable patient
    • Intubated patient WITH a known pneumothorax WITHOUT a chest tube.
    • Patient without adequate sedation/analgesia.
  57. Paramedic Protocol 2018(Rev. 1-2-18) - INTER-FACILITY TRANSFER PORTABLE VENTILATOR – How often are vital signs taken? Pg 103
    Every 5 minutes
  58. Ambulance Destination Decision Policies and Procedures Revised 7-11-17 - Who shall be informed of destinations decisions and ambulance assignments on an MED-ALERT?*** pg 13
    The incident commander (IC)
  59. Paramedic Protocol 2018(Rev. 1-2-18) When is Transcutaneous Cardiac Pacing (TCP) used?*** pg 25
    For symptomatic bradycardia (poor perfusion)***
  60. Paramedic Protocol 2018(Rev. 1-2-18) What is the rate for external cardiac pacing?### pg 26
    • Rate = 80
    • Ma= 50-90 adjust until capture
  61. Paramedic Protocol 2018(Rev. 1-2-18) What can’t a paramedic transport on an inter-facility transfer?### pg 5
    Any med outside of our scope of practice###. (Unless such medication or medical procedures are self-monitored and administered by the patient or patient family members authorized by the patient physician and the transport originates within the pre-hospital phase of care.)
  62. Paramedic Protocol 2018(Rev. 1-2-18) Can a medic transfer patients with blood products, potassium, NTG drips, and heparin drips?*** Pg 5
    • Only - Potassium not more than 40 mEq***
    • Blood products, Heparin and Nitroglycerin have been discontinued as of 1-3-18 Memo
  63. Paramedic Protocol 2018(Rev. 1-2-18)When can you discontinue CPR in a cardiac arrest patient by paramedic personnel?### pg 15
    • When information comes available that would have prevented you from starting CPR (DNR found, etc.)
    • Witnessed traumatic arrest with effective airway management and IV therapy and transport to ED or Trauma Center is greater than 15 minutes.
  64. Paramedic Protocol 2018(Rev. 1-2-18)You are working up a cardiac arrest patient in the back of the ambulance at the scene and have not began transport, base physician advises to discontinue resuscitation, what do you do?### pg 16
    Discontinue CPR, remain at scene with patient in your ambulance until released by law enforcement agency with investigative authority or coroner.
  65. Paramedic Protocol 2018(Rev. 1-2-18)You receive base orders to discontinue CPR while en-route to the hospital, what do you do?### pg 16
    Stop CPR, continue Code 2 to the closest most appropriate receiving hospital or base hospital.
  66. Paramedic Protocol 2018(Rev. 1-2-18) You’re in the East Kern and receive orders from a base hospital in the Bakersfield area to discontinue CPR, what do you do?### pg 16
    Discontinue CPR, proceed Code 2 to the closest most appropriate receiving facility. Make contact with that facility ASAP and inform the ED of the situation. In this situation you’re going to transport to either, AVH, RCH or KVH and contact them with the situation.
  67. Where do you transport a medical extremis patient?### (Amb Hospital Destination (Rev 7-11-17) pg 5
    The closest hospital ED not on closure status.
  68. What is ALS Extremis Criteria?### Amb Hospital Destination (Rev 7-11-17) pg 5
    • Unmanageable airway or resp. arrest
    • Uncontrolled hemorrhage with signs of hypovolemic shock
    • Cardiopulmonary arrest
  69. What must the paramedic do before leaving the hospital after delivering a patient to the ED?### (UTL)
    The paramedic must leave a completed patient care report with the facility before leaving, either hand written on the county form or printed from their digital PCR device
  70. How long do you have to complete a (digital) PCR?### (UTL)
    A medic has 15 hours from call time to complete digital PCR’s
  71. When can a patient be transported to a closed hospital ED?### Amb Hospital Destination (Rev 7-11-17) pg 5
    When the patient is in extremis status and the ED is not on internal disaster closure.
  72. What is the purpose on an MCI activation?### Amb Hospital Destination (Rev 7-11-17) pg11
    For proper management of incidents involving more than 5 patients, an incident involving a hazardous materials exposure regardless of the number of patients, and a serious or unusual overload of the EMS system as determined by the EMS Division.
  73. Who can activate the trauma system?### Trauma Policies (Rev 7-12-15) pg 4
    Fire based EMT and paramedic first responders can activate step 1 and 2 trauma activations. BLS transport EMTs can activate step 1 and 2 trauma activations. ALS and BLS transport personnel can activate step 1,2,3,4 activation but should consider consult with the trauma center before activating step 3 and 4 activations.
  74. Paramedic Protocol 2018(Rev. 1-2-18)Where do you decompress the chest for patients with a tension pneumothorax?### pg 83
    Mid-clavicular between the 2-3rd rib (2nd intercostal space) or Mid-axilliary between the 4-5th rib (4th intercostal space).
  75. Paramedic Protocol 2018(Rev. 12-28-18)When is it OK to use Versed for conscious intubation?### pg 61
    Patients with Burns after the patient has been intubated.
  76. Paramedic Protocol 2018(Rev. 1-2-18) Is it Ok to stay on-scene with a patient with a suspected MI to obtain a 12-lead?###
    The Chest Pain protocol states, “do not delay treatment or transport beyond 2-3 minutes to obtain a 12-lead ECG.
  77. Paramedic Protocol 2018(Rev. 1-2-18)When is it Ok to hyperventilate a patient with head trauma?###
    • Hyperventilation IS indicated for patients with rapid deterioration and signs of impending herniation, such as-
    • Rapidly deteriorating mental status
    • Contralateral paralysis/weakness
    • Unilateral dilated pupils
    • Decerebrate or decorticate posturing
  78. Paramedic Protocol 2018(Rev. 1-2-18) What are the approved drugs for MADD###
    • Narcan
    • Versed
    • Fentanyl
  79. Paramedic Protocol 2018(Rev. 1-2-18) What are the contraindications of MS?###
    • Hypotension
    • Head trauma
    • Acute asthma
    • known hypersensitivity to MS
  80. Paramedic Protocol 2018(Rev. 1-2-18)What are the precautions of MS administration?###
    • Elderly patients
    • Children
    • Debilitated patients
    • Have narcan readily available
  81. Paramedic Protocol 2018(Rev. 1-2-18) Where do you perform a cricothrotomy?###
    The cricothyroid membrane.
  82. Paramedic Protocol 2018(Rev. 1-2-18) Where do you start an IO?###
    The tibial-tuberosity 2’’ below the medial malleolus.
  83. Paramedic Protocol 2018(Rev. 1-2-18) What is the medication for associated pain admin of an IO.###
    • Lidocaine prior to saline flush.
    • Adult: 40 mg
    • Peds: 0.5 mg/kg to 40 mg max.
  84. What are KCEMS approved patient restraints?###
    Commercially manufactured devices intended for patient restraint.
  85. How much time savings is required for a patient to meet air transport criteria?###
    10 minutes transport time savings. (Trick question, add up flight time + onload & offload times)
  86. What is the age cutoff for pediatric patients?###
    • Medical:
    • Infant =<1
    • Child = 1-8
    • Adult = Greater than 8 yrs old
    • Trauma:
    • Pediatric = birth to age 14
    • Adult: is 14 + 1 day (Trick answer child over 13 years of age)
  87. What are the contraindications of saline lock use?###
    If patient has a risk for hypoperfusion, (cardiac arrest, burn patients, trauma, shock)
  88. What are the indications for saline lock?###
    Patients that require IV access but don’t require fluid administration, blood draw, med admin, etc.
  89. Paramedic Protocol 2018(Rev. 1-2-18) Can you administer Versed with CPAP?### pg96
    YES, IV/IO/MADD
  90. Paramedic Protocol 2018(Rev. 1-2-18) What are the contraindications of CPAP?### pg95
    Agonal or absent breath sounds, suspected pneumothorax or penetrating chest injury, pt. w/ tracheostomy, BP less than 90, aspiration risk (N/V, epistaxis, facial trauma).
  91. Paramedic Protocol 2018(Rev. 1-2-18) What meds can a paramedic transport during an interfacility transfer?###
    Any meds within the paramedic scope of practice, even at higher doses with a physician order. Arterial lines, pre-existing thoracostomy tubes, Potassium Chloride = to or less than 40 mEq, NG tubes, NTG drips. This question is written as a negative, watch the wording. What can’t a paramedic transport on an interfacility transfer?
  92. Once you stop a NTG drip can you restart it?###
    Yes you can, if drip is interrupted you can restart the line and restart the drip
  93. You have a trauma patient that’s 25-30 minutes from the trauma center via ground, the air ambulance is 15 minutes out. By what means do you transport them?###
    By ground, there’s no 10 min time savings
  94. Paramedic Protocol 2018(Rev. 1-2-18) What is the Bradycardic treatment protocol sequence?###
    • Atropine
    • TCP
    • Epinephrine Drip
    • Dopamine Drip
  95. For a level 3 activation what should the medic not do?###
    Utilize helicopter to transport to highest trauma facility
  96. If a doctor on scene, become primary patient care authority do they need to accompany the patient to the hospital?###
    Yes
  97. What classes are required by KCEMS?###
    • ACLS
    • PHTLS
    • PALS
    • CPR
    • Skills Verification
  98. Paramedic Protocol 2018(Rev. 1-2-18)Who is the KCEMS medical director?###
    Kristopher Lyons
  99. Paramedic Protocol 2018(Rev. 1-2-18) Ped volume resuscitation protocol for NS?###
    • Fluid resuscitation for hypovolemic shock begins with a rapid infusion of 20 ml/kg of NS
    • Fluid boluses may be repeated in 20 mL/kg increments up to 60 mL/kg.
    • Make base station contact for further direction if child remains hypotensive after 60 mL/kg fluid challenge without response.
  100. What is the Lasix dosage in KC?###
    Not used any longer (trick question)
  101. Paramedic Protocol 2018(Rev. 1-2-18) Ped/Infant cardiac asystole treatment sequence?###
    • CPR IMMEDIATELY FOR 5 CYCLES
    • EPINEPHRINE 0.01 MG/KG IV/IO REPEAT EVERY 3-5 MINUTES
    • Look for reversible causes
  102. Paramedic Protocol 2018(Rev. 1-2-18) Intubation covered under what level of protocol?###
    Level I
  103. Paramedic Protocol 2018(Rev. 1-2-18) What is the VERSED dose for seizures for a non pregnant patient?### pg 79
    • VERSED 0.1MG/KG IV/IO MAX 5MG PER DOSE
    • VERSED 0.2MG/KG IM MAX 5MG PER DOSE
    • VERSED 0.2 MG/KG IN MAX VOLUME 1 ML PER NOSTRIL
  104. Paramedic Protocol 2018(Rev. 1-2-18) What is the Valium dose for seizures for a non pregnant patient?### pg 79
    • ADULT: VALIUM 5MG IV/IO
    • PEDS: VALIUM 0.3 MG/KG IV/IO
    • TO A MAX DOSE OF 5 MG/
    • RECTAL 0.5 MG/KG TO A MAX DOSE 10 MG
  105. Paramedic Protocol 2018(Rev. 1-2-18) What is the medication for a PEDS patient in SEVERE DISTRESS NOT RESPONDING TO OTHER INTERVENTIONS? Pg 77
    • MAGNESIUM SULFATE Pediatric dosage###
    • PEDS: 40 MG/KG MAX: 2 G over 30 MIN
  106. Paramedic Protocol 2018(Rev. 1-2-18) Patient has a CVA and SPO2 is at 99%, how much oxygen do you give?### pg 31
    None
  107. Paramedic Protocol 2018(Rev. 1-2-18) All patients in respiratory distress can use CPAP?### pg 95
    False
  108. Paramedic Protocol 2018(Rev. 1-2-18) How much of a bolus do you give in cardiac arrest after administering EPI?### pg 20
    20ml
  109. Paramedic Protocol 2018(Rev. 1-2-18) How many extremist criteria are there?###
    Two, medical and trauma
  110. Paramedic Protocol 2018(Rev. 1-2-18) What meds can be administered though the ET tube?###
    None, no longer allowed
  111. Paramedic Protocol 2018(Rev. 1-2-18) What is the approved method for C-spine?### pg 97 & 98
    • C-Collar
    • Seatbelts or straps
    • Head blocks man be used to keep patient from rotating
    • No backboards
  112. Paramedic Protocol 2018(Rev. 1-2-18) When may you leave a patient on a backboard?### pg 98
    When removing patient from device interferes with critical treatments or interventions.
  113. Paramedic Protocol 2018(Rev. 1-2-18) What are the contra-indications for Nitro?### pg 29
    • Suspected or known that the patient has taken sildenafil (Viagra) or vardenafil (Levitra) within the previous 24 hours or tadalafil (Cialis) within the previous 48 hours.
    • Systolic blood pressure less than 90 mm Hg or heart rate less than 50 beats per minute.
  114. Paramedic Protocol 2018(Rev. 1-2-18) What is the approved drug for restraining a patient?### pg 69
    Versed, and requires a Base Station Order
  115. Where is an EMS Satelite Stroke Center?###
    Trick question, There is not one
  116. Paramedic Protocol 2018(Rev. 1-2-18)What is not a serious sign or symptom of infant tachycardia?###
    Insomnia
  117. What is the max dose of Atropine in Cardiac Arrest?###
    None Trick question (Atropine is no longer used)
  118. Paramedic Protocol 2018(Rev. 1-2-18) What is the antidote for Beta Blockers?###
    Glucagon- Adults 2mg IV/IO, PEDS 0.1mg/kg slow IV/IO
  119. Paramedic Protocol 2018(Rev. 1-2-18) What is the antidote for Tricyclic Antidepressants?###
    Sodium Bicarb - 1MeQ/kg IV/IO
  120. When can you not take a step 1 or 2 trauma patient to a type 2 trauma center?###
    You must make contact with the Type 2 Trauma Center and get their input on the destination decision
  121. Paramedic Protocol 2018(Rev. 1-2-18) What meds can be used for MAD?
    Narcan, Versed, Fentanyl.
  122. Who can deactivate a trauma activation?
    Only EMS transporting agencies can deactivate.
  123. Can ALS 1st responders deactivate a Trauma Activation?
    No
  124. Can EMS (county ems) divert ambulances during an MCI?
    Yes
  125. Who is in charge of patient care during an incident?
    Highest medical authority (Usually Halls Supervisor)
  126. Paramedic Protocol 2018(Rev. 1-2-18) Which hospitals are ob/gyn and neonatal?
    KM, BMH, Adventist, MSW
  127. Paramedic Protocol 2018(Rev. 1-2-18) Which hospitals are orthopedic hospitals?
    Adventist, KM, BMH MSW, Mercy (answer was all of the above)
  128. Paramedic Protocol 2018(Rev. 1-2-18)Load and go situations in trauma "EXCEPT" are ALOC, bilateral femur fx, pelvis fx, or Tib fib fx
    Answer is "EXCEPT" compound Tib fib fx
  129. Paramedic Protocol 2018(Rev. 1-2-18) What is a contraindication of a saline lock?
    Possible of becoming or are HYPOTENSIVE
  130. Paramedic Protocol 2018(Rev. 1-2-18) True or false: does the helmet have to be removed for spinal restriction?
    No
  131. Paramedic Protocol 2018(Rev. 1-2-18) Which hospital is for sexual assault?
    Adventist Health
  132. Paramedic Protocol 2018(Rev. 1-2-18) Which hospital is for burns?
    BMH
  133. Paramedic Protocol 2018(Rev. 1-2-18) What is the STEMI time frame?
    30 min
  134. Paramedic Protocol 2018(Rev. 1-2-18) Do you provide spinal restriction for chronic back pain?
    No
  135. Paramedic Protocol 2018(Rev. 1-2-18) What is the Respiratory distress protocol order?
    • Duo neb (Albuterol and Atrovent)
    • Consider CPAP
    • Epinephrine
    • Mag Sulfate
    • Positive pressure ventilations (BVM)
  136. Paramedic Protocol 2018(Rev. 1-2-18) When can you transport to a closed receiving facility?
    Never
  137. Paramedic Protocol 2018(Rev. 1-2-18) Where do you take a pediatric emergent patients?
    • BMH
    • KM
  138. Paramedic Protocol 2018(Rev. 1-2-18) Where do you take a pediatric extremis patients?
    Closest open hospital
  139. Paramedic Protocol 2018(Rev. 1-2-18) Intubation and Cricothyrotomy are what level protocols?
    • Intubation Level I 
    • Cricothyrotomy Level II
  140. Paramedic Protocol 2018(Rev. 1-2-18) Is a complete LBBB a stemi notification?
    No
  141. Paramedic Protocol 2018(Rev. 1-2-18) Preferred route for meds in a cardiac arrest patient?
    Not the ET tube.
  142. Paramedic Protocol 2018(Rev. 1-2-18) How many trauma centers are in Kern County?
    2 (KMC and Ridgecrest is a level 4 trauma ctr. )
  143. Paramedic Protocol 2018(Rev. 1-2-18) Serious signs and symptoms are unlikely to be present with a heart rate of ?
    Less than 150 BPM
  144. Paramedic Protocol 2018(Rev. 1-2-18) When do you need to hyperventilate a patient?
    Herniation of Head trauma
  145. Paramedic Protocol 2018(Rev. 1-2-18) Low energy unsynchronized shocks can cause?
    VF
  146. Paramedic Protocol 2018(Rev. 1-2-18) How much of morphine must be carried if fentanyl is not available?
    40mg
  147. Paramedic Protocol 2018(Rev. 1-2-18) Does restraints on a 5150 patient qualifies for a medical complaint?
    Yes
  148. Paramedic Protocol 2018(Rev. 1-2-18) If there is confusion between SVT and VT due to the wide complexes, what should you do?
    Assume it's VT.
  149. Paramedic Protocol 2018(Rev. 1-2-18) Bougie and flexguide can be used for a tube, true false?
    True
  150. Paramedic Protocol 2018(Rev. 1-2-18) Time frame of CVA onset to TPA is?
    4hrs
  151. Paramedic Protocol 2018(Rev. 1-2-18) Hypothermic hospitals 2 of them?
    • Adventist Health
    • BMH
  152. Paramedic Protocol 2018(Rev. 1-2-18)Can a burn patient with no trauma go to any hospital?
    No BMH only
  153. Know signs of herniation, all answers are correct EXCEPT ?
    Contralateral numbness/weakness
  154. Paramedic Protocol 2018(Rev. 1-2-18) Can you use a saline locks on burn patients?
    NO
  155. Paramedic Protocol 2018(Rev. 1-2-18) Ped trauma fluid dose?
    • 10-20ml/kg
    • Repeated to a max dose of 60ml/kg
  156. Paramedic Protocol 2018(Rev. 1-2-18) A child in a booster seat may need extrication and spinal immobilization?
    True
  157. Who must you notify immediately when leaving the scene of a trauma activation, if it doesn’t delay transport.
    The trauma center
  158. A physician taking over patient care does not have to ride in the ambulance?
    False
  159. An ambulance is not required for a 5150 with no medical complaint?
    True
  160. An ER can divert an ambulance to another ER?
    False
  161. Paramedic Protocol 2018(Rev. 1-2-18) Signs and symptoms of herniation include all of the following except: Low HR, low BP, increased RR, or paradoxical pulse pressure?
    paradoxical pulse pressure
  162. Paramedic Protocol 2018(Rev. 1-2-18) What stroke scale does Kern county Use?
    Cincinnati stroke scale
  163. Paramedic Protocol 2018(Rev. 1-2-18) If a patient is requesting a hospital that has a score greater then 5, you take them to a lower scored hospital against their will?
    False
  164. Which is not needed to recert in Kern county? PHTLS, ACLS, PALS, AMLS
    AMLS
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Paramedic Test Prep Study Guide
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